Making sure a victory takes hold…

By
Blog Admin January 23, 2007

It is true that we all pay a cost for the broken health care system, of having so many uninsured patients. It’s one of the reasons why everybody has an interest in covering the uninsured. However, let’s not leave the impression that the uninsured get off with free care now.

Far from it. The uninsured often are asked to pay *more* than anybody else in the system, whether for prescription drugs, or for hospital care. The financial repercussions for being uninsured include severe medical debt and personal bankruptcy.

This article in the Sacramento Bee over the holidays shows a case in point. Megan was working but in the waiting period of her job before getting coverage (in her case, a few months, but many employers now make workers or their families wait a year or three being being eligible for coverage). She was riding her bicycle and broke her arm. Like many uninsured patients, she knew the financial hit she was about to take, and took steps–sometimes dangerous to her own health–to avoid expenses. In her case, she explicitly did not call an ambulance, and relied on other ways to get to a hospital. Still, her bill for the hospital visit to get a splint was over $6,000. She incurred other bills from the actual doctors at the hospital, and in follow-up visits, in her path to recovery.

Let’s focus on the biggest bill from the hospital. That bill was three or four times larger than insurers get charged for the same service. Insurers have the ability to negotiate down from the “sticker price.” Individual consumers, lacking market power, get the main bill.

But that’s hopefully going to change. Because of pressure from consumer groups, investigations from Congress, pending legislation in California, and class-action lawsuits, hospitals have begun to change their billing practices, to allow uninsured patients to get a fair price for services.

At the end, Megan was able to pay a rate similar to what Medicare pays for such a service. It’s still a lot of money–over $1,500. But for many people, the $5,000 difference is the difference between debt and bankruptcy.

A new law passed this year in California, AB774(Chan), sponsored by Health Access California, to ensure that many uninsured and underinsured patients are not overcharged at hospitals. But as in the case of Megan, it’s critical that patients know about their rights and options in the first place. Megan would not have known about the policy at the hospital if she wasn’t a friend of mine.

I’m presenting on this landmark bill as part of a panel on medical debt at the Families USA conference in Washington, DC on Thursday. I wouldn’t be surprised if you have many states pursuing this type of common-sense remedy.